Updated: 03/07/2014 7:10 PM KSTP.com By: Stephen Tellier
Advanced practice nurses in Minnesota say they want more authority to take care of patients without doctor supervision. Across the state, nurses are already taking on more responsibilities as more doctors retire, and the possibility of a serious doctor shortage in Minnesota becomes very real.
According to the Association of American Medical Colleges, there were nearly 15,000 active physicians in Minnesota in 2012. The Minnesota Department of Health says by the year 2020, Minnesota could be short by up to 3,000 doctors.
“How are we going to try and address a potential physician shortage?” asked Dave Thorson, a family physician and the chair of the board of trustees for the Minnesota Medical Association.
Nearly one in four physicians in Minnesota is over the age of 60. Mary Chesney, the director of the Doctor of Nursing Practice Program at the University of Minnesota and the president of the Minnesota Advanced Practice Registered Nurse Coalition, says one bill can help replace those doctors when they retire.
"We think this bill is incredibly important for bringing quality, high-quality, safe health care to Minnesotans,” Chesney said.
The bill expands what advanced practicing nurses can do. For example, "nurse practitioner" would mean, “providing health assessment and screening activities,” “diagnosing, treating, and facilitating patients' management of their acute and chronic illnesses and diseases," and writing prescriptions. They would do so independent of physicians for the first time.
“It takes those barriers away, and it allows everyone to fully practice to the fullest extent of their education and training,” Chesney said. “When one profession can limit where and with whom another profession can practice, it really does decrease choice.”
When asked whether nurse practitioners should be allowed to practice independently, Thorson replied, “I think that when you talk about the transformation of care to team-based care, as you start having more people practicing independently, you are fragmenting the team, not encouraging team-based case.”
Thorson said the industry is already working to solve the shortage, with improvements like better technology and fewer in-person appointments. He also said as skilled as advanced practice nurses are, they're not doctors.
“We have to figure out how we can allow patients to have access and yet protect patient safety by making sure they're being seen by people who are practicing within their training and expertise,” Thorson said.
At least 18 other states allow some nurses to work without being supervised by a physician, including Iowa and North Dakota.
Doctors have also proposed a number of other ways to address the doctor shortage, including improving incentives for primary care doctors, keeping some doctors working part-time even after retirement, or providing better pay for medical students.